Conectar
by Sabine Scully, Bernadette Earley, Paul E. Smith, Matthew S. J. Finnie, Catherine McAloon, Frank Buckley, David A. Kenny, Sinéad M. Waters
There is increasing evidence to support the existence of a naturally occurring colostral microbiome, which may influence the development of the gastrointestinal microbiota and immune function of the calf. The objective of this study was to characterize the prokaryotic community of colostrum collected fresh (within 2h parturition) from primi- and multiparous Holstein-Friesian (n = 17) and Jersey (n = 10) cows. Extracted microbial DNA underwent qPCR and Illumina amplicon sequencing of the V4 region of the 16S rRNA gene. High throughput amplicon sequencing data was analysed using a variety of R packages. Taxonomy was assigned using the SILVA database (v. 138.1). No effect of breed or parity was observed on alpha (α; Shannon) diversity and community composition. The mean Shannon score was 3.33 (SE 0.14), indicating a diverse community within sample. A total of 681 genus-level amplicon sequence variant (ASV) groups were identified prior to filtering for relative abundance (RA) of >0.05%. Nineteen bacterial genera were identified as core. The predominant bacterial phyla observed were Bacillota, Pseudomonadota, and Actinomycetota. Community membership consisted of common gut commensals, with many members exhibiting diverse metabolic functions. Within the archaeal community, Methanobrevibacter had the highest RA, accounting for 85.99%. No observed differences between breeds suggests that farm origin may be more influential than breed on microbiota composition. The presence of archaea and strict anaerobes highlights the need to investigate the existence of an entero-mammary pathway in cattle. This is the first study jointly characterising bacteria and archaea in colostrum from different breeds from the same dairy herd under pasture-based conditions. The diverse bacterial community observed warrants further investigation into its role in calf health in early life. Specific microbes, like Lachnospiraceae, should be investigated for their potential in the development of probiotics and preventative practices for better calf health.To evaluate clinical nurses' perceptions and acceptability of procedure videos developed to support them during rare clinical procedures. In addition, a secondary aim was to investigate whether these videos reduce anxiety and enhance clinical reasoning.
A descriptive multi-methods study within a pre-post-implementation evaluation design.
Seven locally developed procedure videos (non-invasive ventilation (n = 2), temporary cardiac pacing (n = 3) and pericardiocentesis (n = 2)) were evaluated using questionnaires before and after a 6-month implementation period at a local health district in Australia. Participants self-rated their clinical reasoning skills in response to video procedures, mapped against the Clinical Reasoning cycle stages. The Spielberger State–Trait Anxiety Inventory (STAI) assessed anxiety towards rare procedures. Data from open-ended questions were analysed using inductive content analysis.
A total of 247 participants completed the pre-implementation questionnaire, and 133 completed the post-implementation questionnaire. Before implementation, many reported feeling heightened anxiety when faced with rare or infrequent procedures, reporting levels that exceeded commonly accepted clinical thresholds for concern. Content analysis revealed persistent concerns among participants, including the need for support during new procedures and a fear of making errors. Before implementation, participants reported searching online for videos to support undertaking new procedures. Following implementation, most participants reported that viewing the videos enhanced their learning experience and improved their clinical reasoning. Perceived anxiety towards undertaking rare procedures was not significantly different from post-implementation.
This study highlights the need for timely support during infrequent clinical procedures, as participants reported anxiety about them. It also demonstrates that procedure videos are valued tools for nurses before rare clinical procedures.
Rare procedures are linked to nurse anxiety and mixed emotions, some of which may be eustress. Organisations can enhance clinical resources for nursing staff by providing online videos tailored to local practices and context, which many nurses find helpful for improving clinical reasoning when undertaking rare procedures.
This study highlights the anxiety nurses experience before rare procedures and the significance of incorporating multimedia resources, especially online videos, in nursing professional development for rarely performed procedures. Additionally, it informs employers about nursing staff preferences.
SQUIRE 2.0 reporting was adhered to.
None.
Acknowledging equality, diversity and inclusion (EDI) in research is not only a moral imperative but also an important step in avoiding bias and ensuring generalisability of results. This protocol describes the development of STAndards for ReporTing EDI (START-EDI) in research, which will provide a set of minimum standards to help researchers improve their consistency, completeness and transparency in EDI reporting. We anticipate that these guidelines will benefit authors, reviewers, editors, funding organisations, healthcare providers, patients and the public.
To create START-EDI reporting guidelines, the following five stages are proposed: (i) establish a diverse, multidisciplinary Steering Committee that will lead and coordinate guideline development; (ii) a systematic review to identify the essential principles and methodological approaches for EDI to generate preliminary checklist items; (iii) conduct an international Delphi process to reach a consensus on the checklist items; (iv) finalise the reporting guidelines and create a separate explanation and elaboration document; and (v) broad dissemination and implementation of START-EDI guidelines. We will work with patient and public involvement representatives and under-served groups in research throughout the project stages.
The study has received ethical approval from the Imperial College London Research Ethics Committee (study ID: 7592283). The reporting guidelines will be published in open access peer-reviewed publications and presented in international conferences, and disseminated through community networks and forums.
The project is pre-registered within the Open Science Framework (https://osf.io/8udbq/) and the Enhancing the Quality and Transparency of Health Research Network.
To survey registered nurses' familiarity with delegation standards and confidence to delegate to unlicenced workers within their practice.
Cross-sectional exploratory survey design.
The survey focused on Australian registered nurses (n = 420). Initial descriptive analysis was undertaken. Additionally, inferential analysis was undertaken between two independent variables focused on familiarity of delegation policy, and confidence to delegate, and several demographic and workplace variables. Stepwise linear regression was undertaken to determine predictors of the two delegation variables. The cross-sectional study was undertaken according to the STROBE reporting checklist.
The majority of respondents were somewhat familiar, or not familiar at all with delegation standards. This pattern was followed for results relevant to confidence delegating to unlicenced workers. Nurses working in adult acute, intensive care and emergency department reported the lowest levels of familiarity with delegation. Additionally, intensive care nurses were significantly less likely to feel very confident delegating to unlicenced support workers. Stepwise regression revealed identifying as male, and working in the public sector were less likely to be confident delegating. Nurses working in the acute setting and public sector were less familiar with delegation standards.
The findings of this study highlight the nuanced nature of delegation to unlicenced workers in Australian nursing settings, with nurses from certain contexts being far less likely to be familiar with or confident undertaking the practice.
The findings of this study have significant implications to increase understanding of nurses diverse contexts of practice and how delegation standards might not be implemented in practice in a confident manner.
To explore the nature and extent of peer-reviewed literature related to the use of diagnostic imaging by nurse practitioners (NPs) to inform future practice and research.
Nurse practitioners undertake advanced assessment, diagnosis, and management of patients, including requesting and interpretation of diagnostic imaging. It is unclear what evidence exists related to the quality use of radiological investigations by NPs in recent years.
A scoping review based on the steps suggested by the Joanna Briggs Institute.
A structured review of the databases Medline, CINAHL and Embase was undertaken using the keywords and MESH terms ‘nurse practitioner’, ‘medical imaging’, ‘diagnostic imaging’, ‘scan’ and ‘radiography’. Only English language articles were included, and no date limit was applied. Database review was completed on 30 May 2021.
Eight themes were identified—country and clinical context, requesting diagnostic imaging, performing diagnostic imaging, image-guided interventions, interpreting diagnostic imaging, training education and knowledge, impact on resource usage and comparison with medical practitioners. There were more studies across a greater breadth of clinical specialties and imaging modalities in the United States than in other countries. Nurse practitioner practice is frequently benchmarked against that of medical colleagues. There is a paucity of studies focusing on educational preparation and the lack of relevant university curricula for NPs around diagnostic imaging.
There are significant gaps in the evidence outside of the United States across several of the identified themes. Further studies are needed to explore NP access to and use of diagnostic imaging and to understand the barriers and facilitators to this.
Studies from four countries were included in this review. The evidence suggests that, where studied, nurse practitioners (NPs) can safely and appropriately request and interpret plain x-rays in the emergency and minor injuries setting. Further research is needed to evaluate the educational needs of NPs in relation to diagnostic imaging and their use of advanced imaging techniques, particularly outside of the United States.
No patient or public contribution.
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